CurrentBlue Cross Blue Shield - WyomingPolicy N/A

Telemedicine, telephone, e-visit, and virtual check-in coverage during COVID-19 (temporary)

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Guidance on BCBSWY coverage and billing for telemedicine, telephone, e-visit, and virtual check-in services during the COVID-19 period (Mar 18–Jun 30, 2020); applies to Blue Cross Blue Shield of Wyoming members and professional providers rendering services to patients at home.

Policy Summary

PayerBlue Cross Blue Shield - Wyoming

PolicyTelemedicine, telephone, e-visit, and virtual check-in coverage during COVID-19 (temporary)

Policy CodePolicy N/A

Change TypeTemporary expansion — home allowed as originating site (Mar 18–Jun 30, 2020)

Effective DateMar 18, 2020

Next Review DateN/A

Key ActionEnsure services billed are appropriate for telemedicine, within scope of license, and use required modifiers (GT for telemedicine; do not use modifier 95).

SourceLink

POLICY UPDATE CHANGES

Benefits extended to services rendered at the patient's home during the COVID-19 crisis.

Mar 18–Jun 30, 2020temporary allowance period

GTtelemedicine modifier

99441-99443telephone CPT codes

99421-99423, G2061-G2063e-visit codes

G2010, G2012virtual check-ins

Telemedicine and Remote Services Coverage Rules

Telemedicine and remote services coverage rules

Temporary coverage and billing guidance during COVID-19:

Benefits extended to services rendered at the patient’s home for the temporary period March 18, 2020 through June 30, 2020.

Only services that can be safely and appropriately rendered via telemedicine should be provided; services that cannot be safely or adequately provided through telemedicine should be avoided.

Telehealth/Telemedicine visits: any HCPCS/CPT that can safely and appropriately be rendered at a distance are allowed, excluding G0425-G0427 and G0406-G0408.

Place of service and modifier rules for telemedicine visits: use standard POS codes (do not bill POS 2) and bill modifier GT; do not bill modifier 95.

Telephone services: codes 99441-99443 are temporarily benefited; use standard POS codes (do not bill POS 2). The GT modifier is not required.

e-Visits (online digital services): codes 99421-99423 and G2061-G2063 are temporarily benefited; use standard POS codes (do not bill POS 2). The GT modifier is not required.

PT/OT/Speech therapy rules for telemedicine and telephone: bill standard therapy codes without GT; to ensure waived patient cost share when applicable bill 99199 with a penny charge for PT/OT/Speech providers.

Virtual check-ins (G2010, G2012) are not reimbursed by BCBSWY at this time.

Billing Codes and Originating Site

Telemedicine and remote service codesmixedCovered

Any HCPCS/CPT	Any code that can safely and appropriately be rendered at a distance (excludes G0425-G0427 and G0406-G0408).
GT	Use GT modifier for telemedicine visits; do not bill modifier 95.
POS standard	Use standard place of service codes; do not bill POS code 2.
99441	Telephone E/M by physician or qualified health professional for established patient.
99442	Telephone E/M by physician or qualified health professional for established patient.
99443	Telephone E/M by physician or qualified health professional for established patient.
99421	Online digital E/M service (e-visit).
G2061	Online assessment service (e-visit).
99422	Online digital E/M service (e-visit).
G2062	Online assessment service (e-visit).

1–10 of 15

1/2

Originating site allowance — COVID-19 temporary change

Temporary originating site allowanceServices rendered to the patient’s home are permitted during the COVID-19 period (effective Mar 18–Jun 30, 2020).

Scope requirementOnly services that can be safely and appropriately rendered at a distance and within the provider’s scope of license meet this allowance.

Place of Service guidanceUse standard place of service codes; do not bill POS code 2 when the patient is at home.

Modifier guidanceFor telemedicine professional visits bill modifier GT; do not bill modifier 95.

Provider Obligations and Billing Rules

Documentation Required

Provider obligations for telemedicine services

No new prior authorization requirements are specified; providers must only deliver and bill for services that can be safely and appropriately rendered via telemedicine and within their scope of license and standard of care. Services that cannot be safely or adequately provided through telemedicine should be avoided.

During the temporary period (Mar 18–Jun 30, 2020) BCBSWY permits telephonic and telemedicine visits to occur to the patient’s home but only for services that can be rendered via telemedicine.
Providers must ensure services billed are within their scope of license and meet the standard of care.

Service Definition and Code Descriptions

Telehealth/Telemedicine Visits

DefinitionAny service that can safely and appropriately be rendered at a distance within the provider’s scope of license and that meets the standard of care; services can be rendered to the patient’s home.

Allowed codesAny HCPCS or CPT code that can safely and appropriately be rendered at a distance (excludes G0425-G0427 and G0406-G0408).

POS/Modifier rulesUse standard place of service codes; do not bill POS code 2. Bill modifier GT for telemedicine visits; do not bill modifier 95.

PT/OT/Speech rulePT/OT/Speech should bill standard codes without GT; to ensure waived patient cost share bill 99199 with a penny charge when applicable.

Telephone Services

DefinitionTelephone evaluation and management service by a physician or other qualified health professional for an established patient.

Accepted CPT codes99441, 99442, 99443.

POS/Modifier guidanceUse standard place of service codes; do not bill POS code 2. The GT modifier is not required for telephone services.

Coverage periodBCBSWY will benefit these services temporarily during the COVID-19 crisis.

e-Visits

DefinitionOnline digital evaluation and management services for an established patient delivered through an online patient portal (e-Visits).

Accepted codes99421, 99422, 99423; G2061, G2062, G2063.

POS/Modifier guidanceUse standard place of service codes; do not bill POS code 2. The GT modifier is not required for e-Visits.

Coverage periodBCBSWY will benefit these services temporarily during the COVID-19 crisis.

Virtual Check-Ins

DefinitionBrief communication technology-based service (virtual check-in) provided to an established patient to report evaluation and management services.

HCPCS/CPT codesG2010, G2012.

Place of service/modifierNot applicable.

Coverage statusThese codes are not reimbursed by BCBSWY at this time.

Policy Summary

PayerBlue Cross Blue Shield - Wyoming

PolicyTelemedicine, telephone, e-visit, and virtual check-in coverage during COVID-19 (temporary)

Policy CodePolicy N/A

Change TypeTemporary expansion — home allowed as originating site (Mar 18–Jun 30, 2020)

Effective DateMar 18, 2020

Next Review DateN/A

Key ActionEnsure services billed are appropriate for telemedicine, within scope of license, and use required modifiers (GT for telemedicine; do not use modifier 95).

SourceLink

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Telemedicine, telephone, e-visit, and virtual check-in coverage during COVID-19 (temporary)

Customize your policy alerts

Sign up for all Blue Cross Blue Shield - Wyoming policy alerts

Know when Blue Cross Blue Shield - Wyoming releases new policies or updates existing guidance.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Telemedicine and Remote Services Coverage Rules

Telemedicine and remote services coverage rules

Temporary coverage and billing guidance during COVID-19:

Benefits extended to services rendered at the patient’s home for the temporary period March 18, 2020 through June 30, 2020.

Only services that can be safely and appropriately rendered via telemedicine should be provided; services that cannot be safely or adequately provided through telemedicine should be avoided.

Telehealth/Telemedicine visits: any HCPCS/CPT that can safely and appropriately be rendered at a distance are allowed, excluding G0425-G0427 and G0406-G0408.

Place of service and modifier rules for telemedicine visits: use standard POS codes (do not bill POS 2) and bill modifier GT; do not bill modifier 95.

Telephone services: codes 99441-99443 are temporarily benefited; use standard POS codes (do not bill POS 2). The GT modifier is not required.

e-Visits (online digital services): codes 99421-99423 and G2061-G2063 are temporarily benefited; use standard POS codes (do not bill POS 2). The GT modifier is not required.

Virtual check-ins (G2010, G2012) are not reimbursed by BCBSWY at this time.

Billing Codes and Originating Site

Telemedicine and remote service codesmixedCovered

Any HCPCS/CPT	Any code that can safely and appropriately be rendered at a distance (excludes G0425-G0427 and G0406-G0408).
GT	Use GT modifier for telemedicine visits; do not bill modifier 95.
POS standard	Use standard place of service codes; do not bill POS code 2.
99441	Telephone E/M by physician or qualified health professional for established patient.
99442	Telephone E/M by physician or qualified health professional for established patient.
99443	Telephone E/M by physician or qualified health professional for established patient.
99421	Online digital E/M service (e-visit).
G2061	Online assessment service (e-visit).
99422	Online digital E/M service (e-visit).
G2062	Online assessment service (e-visit).

1–10 of 15

1/2

Originating site allowance — COVID-19 temporary change

Temporary originating site allowanceServices rendered to the patient’s home are permitted during the COVID-19 period (effective Mar 18–Jun 30, 2020).

Scope requirementOnly services that can be safely and appropriately rendered at a distance and within the provider’s scope of license meet this allowance.

Place of Service guidanceUse standard place of service codes; do not bill POS code 2 when the patient is at home.

Modifier guidanceFor telemedicine professional visits bill modifier GT; do not bill modifier 95.

Provider Obligations and Billing Rules

Documentation Required

Provider obligations for telemedicine services

During the temporary period (Mar 18–Jun 30, 2020) BCBSWY permits telephonic and telemedicine visits to occur to the patient’s home but only for services that can be rendered via telemedicine.
Providers must ensure services billed are within their scope of license and meet the standard of care.

Service Definition and Code Descriptions

Telehealth/Telemedicine Visits

Allowed codesAny HCPCS or CPT code that can safely and appropriately be rendered at a distance (excludes G0425-G0427 and G0406-G0408).

POS/Modifier rulesUse standard place of service codes; do not bill POS code 2. Bill modifier GT for telemedicine visits; do not bill modifier 95.

PT/OT/Speech rulePT/OT/Speech should bill standard codes without GT; to ensure waived patient cost share bill 99199 with a penny charge when applicable.

Telephone Services

DefinitionTelephone evaluation and management service by a physician or other qualified health professional for an established patient.

Accepted CPT codes99441, 99442, 99443.

POS/Modifier guidanceUse standard place of service codes; do not bill POS code 2. The GT modifier is not required for telephone services.

Coverage periodBCBSWY will benefit these services temporarily during the COVID-19 crisis.

e-Visits

DefinitionOnline digital evaluation and management services for an established patient delivered through an online patient portal (e-Visits).

Accepted codes99421, 99422, 99423; G2061, G2062, G2063.

POS/Modifier guidanceUse standard place of service codes; do not bill POS code 2. The GT modifier is not required for e-Visits.

Coverage periodBCBSWY will benefit these services temporarily during the COVID-19 crisis.

Virtual Check-Ins

DefinitionBrief communication technology-based service (virtual check-in) provided to an established patient to report evaluation and management services.

HCPCS/CPT codesG2010, G2012.

Place of service/modifierNot applicable.

Coverage statusThese codes are not reimbursed by BCBSWY at this time.